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Early diagnosis is critical, particularly given the shared clinicoepidemiologic features between advanced rheumatoid arthritis\u2013associated <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content>) and idiopathic pulmonary fibrosis (<jats:styled-content style=\"fixed-case\">IPF<\/jats:styled-content>). This study was undertaken to define the molecular basis of this overlap through comparative profiling of serum proteins in <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IPF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multiplex enzyme\u2010linked immunosorbent assays (<jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content>s) were used to profile 45 protein biomarkers encompassing cytokines\/chemokines, growth factors, and matrix metalloproteinases (<jats:styled-content style=\"fixed-case\">MMP<\/jats:styled-content>s) in sera obtained from <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> patients with <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> and those without, individuals with <jats:styled-content style=\"fixed-case\">IPF<\/jats:styled-content>, and healthy controls. Levels of selected serum proteins were compared between patient subgroups using adjusted linear regression, principal component analysis (<jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content>), and least absolute shrinkage and selection operator (<jats:styled-content style=\"fixed-case\">LASSO<\/jats:styled-content>) modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multiplex <jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content>\u2010based assessment of sera from 2 independent cohorts (Veterans Affairs [VA] and Non\u2010<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content>) revealed a number of non\u2010overlapping biomarkers distinguishing <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> without <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2013no <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content>) in adjusted regression models. Parallel analysis of sera from <jats:styled-content style=\"fixed-case\">IPF<\/jats:styled-content> patients also yielded a discriminatory panel of protein markers in models adjusted for age\/sex\/smoking, which showed differential overlap with profiles linked to <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> in the <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> cohort versus the Non\u2010<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> cohort. <jats:styled-content style=\"fixed-case\">PCA<\/jats:styled-content> revealed several distinct functional groups of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content>\u2013associated markers that, in the <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> cohort, encompassed proinflammatory cytokines\/chemokines as well as 2 different subsets of <jats:styled-content style=\"fixed-case\">MMP<\/jats:styled-content>s. Finally, <jats:styled-content style=\"fixed-case\">LASSO<\/jats:styled-content> regression modeling in the Non\u2010<jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">VA<\/jats:styled-content> cohorts revealed distinct biomarker combinations capable of discriminating <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2013no <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Comparative serum protein biomarker profiling represents a viable method for distinguishing <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\u2013no <jats:styled-content style=\"fixed-case\">ILD<\/jats:styled-content> and identifying population\u2010specific mediators shared with <jats:styled-content style=\"fixed-case\">IPF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41123","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T08:09:17Z","timestamp":1568794157000},"page":"409-419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Comparative Profiling of Serum Protein Biomarkers in Rheumatoid Arthritis\u2013Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis"],"prefix":"10.1002","volume":"72","author":[{"given":"Daniel J.","family":"Kass","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh 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